Vaccination Services Must Continue Even as We Fight COVID-19
By Dr. Chizoba Wonodi, Immunization Technical Lead, USAID’s MOMENTUM 2A: Global Technical Leadership and Targeted Technical Assistance
Nigeria, like all other countries in the world, is grappling with the devasting public health, social, and economic fallouts of the COVID-19 pandemic. As of April 27, 2020, Nigeria has 1273 confirmed cases, a dramatic increase since February 28, when the first infection was reported in the country. Of these cases, the Nigeria Centre for Disease Control (NCDC) reports 40 deaths and 239 discharges. To curb the virus’s spread, the federal government shut all national land, sea, and air borders and imposed a stay-at-home order, setting limits on mass gatherings and movement in the three most affected states: Lagos, Abuja, and Ogun. Other states have since adopted these measures. Despite these actions, cases continue to spike, raising concerns that community transmission has taken root.
Abuja is in its fourth week of lockdown. Hospitals and clinics, both public and private, remain open, but many have put routine services like vaccinations on hold. This is concerning. A friend with a pediatric consulting clinic in Abuja tells me, “mothers are calling from all over the country frantically asking me where to get their children vaccinated as their usual places are closed.” To continue offering immunization services, she must buy personal protective equipment (PPE) for her vaccinators, which adds to the cost of the service. While the rich can pay, the poor cannot. Access and equity are declining.
World Immunization Week is a time to remember the crucial value of vaccines and the need to make immunization services available to all who need them even in the face of COVID-19. Vaccine-preventable diseases such as pneumonia, diarrhea, malaria, measles, and tetanus account for about a third of all child mortality in Nigeria. As we fight the coronavirus, we must not lose sight of why vaccines matter always. Consider the measles vaccine, whose worldwide use helped to reduce measles death by 80% between 2000 and 2017, saving 21 million lives. Just like COVID-19, the measles virus is highly contagious, so a high level of coverage is needed to avoid outbreaks. If children miss vaccinations, deaths can result. In January 2020, the NCDC reported 1,618 suspected cases of measles. We don’t want that. More children will likely die in a measles outbreak than from COVID-19.
This problem is not unique to Nigeria. Other countries facing the COVID-19 pandemic must be alert to threats to their immunization and essential health programs. The World Health Organization has developed guidance for how countries can maintain immunization and essential health services during the pandemic. Effective infection control measures are needed to protect service providers and patients—and inspire public confidence to continue to seek care in health facilities.
Health workers must be equipped with the knowledge and tools to continue providing services safely, and the right messages for communities to prevent transmission. They must have PPEs to protect themselves and need masks for their clients. All clinics must have water, sanitation and hygiene (WASH) facilities, the space for social distancing, and room to separate patients with features of COVID-19 from those with none, so all clients can be attended to safely. Countries need a coordinated approach to learn and share one another’s best practices, but the best solutions will be adapted to local realities. MOMENTUM 2A: Global Technical Leadership and Targeted Technical Assistance, a new U.S. Agency for International Development-funded project, has experts and partners in several African and Asian countries that can support national and subnational governments, as well as civil society organizations, to determine how to keep their clinic doors open for essential services.
Let us join hands to advocate safe immunization services for all who, deliver, or receive them. Encourage your government today to provide WASH for clinics and PPEs for health workers. They must put mechanisms in place to ensure immunization and essential health services can continue in the face of health emergencies.